Factors associated with incomplete treatment among leprosy patients in Sabah, Malaysia, between 2012 and 2016

Background

Leprosy remains a public health concern, especially in developing countries. Despite the availability of multidrug therapy (MDT), treatment adherence continues to challenge control programmes. In Malaysia, most new leprosy cases are reported in Sabah, indicating ongoing transmission. The World Health Organization highlights the need to ensure treatment adherence to prevent complications and interrupt transmission.

Objective

To describe the sociodemographic and clinical characteristics of leprosy patients in Sabah and identify factors associated with incomplete treatment between 2012 and 2016.

Methodology

A retrospective record review was conducted using secondary data from the Sabah State Health Department. Cases registered between 2012 and 2016 were included if treatment was scheduled to be completed before 1 January 2019.

Results

Of 243 patients, 44 (18.1%) did not complete treatment. Most were of working age (84.4%) and male (73.7%). Over half were non-Malaysians (55.1%), primarily Indonesians (67.2%) and Filipinos (32.8%). Cases were concentrated in the East Coast area of Sabah. Deformity at diagnosis was present in 41.6% of patients. Incomplete treatment was significantly associated with Indonesian nationality (adjusted OR: 4.70; 95% CI: 2.03–10.90; p < 0.001) and absence of deformity at diagnosis (adjusted OR: 0.24; 95% CI: 0.11–0.56; p = 0.001).

Conclusion

Incomplete treatment was significantly associated with foreign nationality, particularly Indonesian, and the absence of deformity at diagnosis. These findings highlight the need for targeted strategies to improve adherence, especially among foreign-born patients and those with milder clinical presentations.